Monday, November 10, 2008

“Our study suggests for the first time that vaccination against influenza may reduce the risk of venous thrombotic embolism (VTE),” said Dr. Joseph Emmerich, lead author of the study and professor of vascular medicine at the University Paris Descartes and head of the INSERM Lab 765, which investigates thrombosis.

“This protective effect was more pronounced before the age of 52 years,” he said while presenting the findings at the American Heart Association’s Scientific Sessions 2008.

VTE, the formation of a blood clot in a vein, is dangerous because the blood clot can break loose and travel through the circulatory system to the right side of the heart. It can further travel to the lungs, where it may prove to be life-threatening or even fatal.

For their research, the team conducted a case-control study among 1,454 age- and sex-matched patients (average age 52 years) from 11 centers in France (the FARIVE study).

The researchers compared 727 patients without personal history of cancer within the last five years who had initial episodes of VTE to a control group of age- and sex-matched patients free of venous and arterial thrombotic disease.

They revealed that patients younger than 18 years old — or those who already had VTE, had a diagnosis of active cancer or a history of malignancy less than five years previously, or had a short life expectancy due to other causes — were ineligible to participate in the study.

Research found that neodymium, a magnetic substance contained in the MP3 player headphones, appears to impede proper functioning of the technology, posing a potential grave risk to patients who rely on the devices.

"Exposure of a defibrillator to the headphones can temporarily deactivate the defibrillator," said William Maisel, senior author of the study and director of the Medical Device Safety Institute at Beth Israel Medical Center in Boston, Massachusetts.

The study, presented at an American Heart Association conference, concluded that in order to be operated safely, headphones accompanying the popular MP3 digital music players must be at least 1.2 inches (3 centimeters) from the implanted devices.

Scientists said patients using heart devices should not place MP3 player headphones in their pocket or drape them over their chest.

"For family members or friends of patients with implantable defibrillators," said Maisel, "they should avoid wearing headphones and resting their head right on top of someone's device."

Maisel and his research team determined that outside studies have found no adverse reactions to pacemakers and defibrillators from other portable electronic devices like iPods, Bluetooth headsets, iPhones, electric blankets or hand-held airport metal detectors.

Leading medical experts are warning patients against using untested remedies advertised on the internet which, they say, sell "false hope".

The group, backed by charity Sense About Science, says vulnerable people are being increasingly exploited by the online promotion of such treatments.

Many untested remedies are expensive and do not work, and are often based on "unreliable" evidence, the experts say.

A new guide has been published to help patients recognise bogus treatments.

Sense About Science says there are now hundreds of websites offering hope to people who are desperate for a cure.

Many online adverts and chat-room conversations testify to the "incredible" benefits of new medicines and treatments, often selling the empty promise of curing the incurable, the charity says.

Some offer stem cell treatments for brain disorders for tens of thousands of pounds. Others sell cures for multiple sclerosis and cancers.

But the evidence behind the remedies is often unreliable, experts say, and patients are increasingly being exploited.

Experts and patient groups want to see tighter regulation to reduce unfounded claims.

Dr Kieran Breen, director of research at the Parkinson's Disease Society, said: "It can be tempting to believe personal stories of miracle cures, but only by using tried and tested methods can we move forward and provide people with Parkinson's with the best available advice and treatments."

Thursday, November 6, 2008

TUESDAY, Nov. 4 (HealthDay News) -- Girls with attention-deficit hyperactivity disorder (ADHD) appear to have better control of their movements than boys with the common mental disorder, a new study says.

The study, published in the Nov. 4 issue of Neurology, found that girls with ADHD and a control group of children without the disorder did twice as well as boys with ADHD in a test that compared their abilities to tap their toes, walk on their heels, maintain balance and keep a steady rhythm. The results of the children, aged 7 to 15, were compared by age as well as gender.

"Our findings suggest that the differences between boys and girls with ADHD show up not only in behavior and symptoms, but also in development of movement control, likely because girls' brains mature earlier than boys' brains," study author E. Mark Mahone, of Johns Hopkins University School of Medicine in Baltimore, said in an American Academy of Neurology news release.

Symptoms of ADHD include impulsiveness, hyperactivity, inattentiveness and constant daydreaming.

Mahone called for more ADHD movement studies that look at boys and girls separately and at younger ages.

NEW YORK (Reuters Health) - Acupuncture is promoted as alternative way to induce labor in women who go past their due date, but a new study finds no evidence that the tactic works.

About 5 percent to 10 percent of pregnant women go 2 weeks or more past their due date, a delay that raises the risk of complications during labor. Because of this, doctors routinely induce labor when a pregnancy lasts beyond 41 weeks.

During standard labor induction, the doctor uses an instrument to rupture the amniotic sac or gives synthetic forms of prostaglandins or oxytocin -- hormones that normally help trigger labor.

Acupuncture has been promoted as an alternative; in theory, it may work by stimulating the nervous system, which in turn could cause the uterus to contract.

But in the new study of 364 pregnant women who were past their due dates, Australian researchers found that 2 days of acupuncture therapy did not reduce the need for standard forms of labor induction.

Dr. Caroline A. Smith and colleagues at the University of Adelaide report the findings in the journal Obstetrics & Gynecology.

Acupuncture has been used for more than 2,000 years in Chinese medicine to treat a wide variety of ailments. According to traditional medicine, specific acupuncture points on the skin are connected to internal pathways that conduct energy, or qi ("chee"), and stimulating these points with a fine needle promotes the healthy flow of qi.

For their study, Smith and her colleagues randomly assigned patients to either undergo real acupuncture or a "sham" version where needles were inserted only superficially, into areas of the skin other than traditional acupuncture points.

Each woman had two sessions performed over the 2 days before her scheduled labor induction.

In the end, Smith's team found, women who had the real acupuncture were just as likely as the comparison group to need any of the standard forms of labor induction and did not have a shorter labor once it was induced.

Still, the researchers conclude, the findings do not prove that acupuncture has no use in inducing labor. They say larger studies should look at whether starting acupuncture sooner, or doing more sessions, aids labor induction.

In the meantime, acupuncture at least seems to do no harm.

"There is no evidence of harm from the administration of acupuncture in the postterm period to the mother or fetus," Smith and her colleagues write, "and women may still seek out the use of acupuncture to prepare for labor."

Monday, November 3, 2008

"Our study suggests that doctors who treat people with chronic diseases should not attribute new neurological symptoms such as numbness and tingling to existing conditions without careful consideration," said study author Ruth Ann Marrie, MD, PhD, of the University of Manitoba in Winnipeg, Canada, and member of the American Academy of Neurology.

For the study, researchers examined the records of 8,983 people who had been diagnosed with MS. Of those, 2,375 were further classified as having mild, moderate or severe disability within two years of diagnosis. This well-characterized group was asked about pre-existing health conditions, their smoking status and weight history.

The study found that it took one to 10 years longer for people who were obese, smoked, or had physical or mental health conditions to be diagnosed with MS compared to people without such conditions. The study also found that the more medical problems a person with MS had, the more severe the disease had become by the time they were diagnosed.

"People with vascular problems or who were obese were about one-and-a-half times more likely to be moderately disabled at the time of diagnosis compared with those who had MS but did not have any heart or weight problems," said Marrie. "We also found people who had a mental disorder or any muscle or joint problem along with MS were nearly two times more likely to be severely disabled at the time of diagnosis."

Marrie says pre-existing conditions are common in the United States and can mask symptoms of a new disease or affect access to patient care. "People with multiple medical problems on top of MS may need more healthcare resources or might respond differently to medication," Marrie said. "This needs more study."

Dr Nicolle Kränkel and colleagues at the Bristol Heart Institute have discovered how our bodies initiate DIY rescue and repair mechanisms when blood supply is inadequate, for example in diabetic limbs or in the heart muscle during heart attack. Their findings also provide a practical step to advance progress in stem cell therapies.

In healthy people, reduced oxygen supply can occur in certain situations, e.g. after an injury. The affected tissues release chemical messengers that 'call' to a type of circulating stem cells (EPCs) for help to re-establish blood supply via the growth of new blood vessels. A group of Bristol researchers have found that kinins, for long time considered inflammatory substances, are among the messengers supporting blood vessel growth.

In this study, published in Circulation Research, Dr Kränkel and colleagues found that EPCs respond to kinins by travelling to the target tissue and invading it to assist healing. In patients with angina, EPCs cannot respond to the distress call because they lack a kinin sensor (the 'kinin receptor') on their surface. The oxygen-starved tissue is therefore left with reduced blood supply.

In heart attack patients they saw that a proportion of the circulating EPCs were able to sense the kinin signal and respond.

The team purified the kinin-sensitive EPCs from the total stem cell population to create an enriched sample that has huge potential as a powerful regenerative therapy.

Dr Kränkel added: "In previous clinical stem cell trials, a mixture of different types of cells were used. We've used kinin like a magnet to attract and extract the most effective repair cells from the mass of different types. This enriched sample should increase the therapeutic potential, especially in heart attack patients where quick and efficient treatment is crucial for long term outcome."

Professor Jeremy Pearson, Associate Medical Director of the British Heart Foundation – one of the study's funders – said: "The team have made fascinating discoveries about our DIY repair systems and have translated them into practical use. They've intelligently employed the body's own strategies to develop a method that may take us a step closer to truly effective stem cell therapies for heart patients."

Dr Kränkel is a research fellow in the laboratory of Paolo Madeddu, Professor of Experimental Cardiovascluar Medicine at the Bristol Heart Institute, Bristol Royal Infirmary.

MONDAY, Nov. 3 (HealthDay News) -- Children of U.S. military personnel deployed to Iraq and Afghanistan are more likely to have behavioral problems than children whose parents aren't deployed, a new study shows.

Researchers studied 169 families with children aged 18 months to 5 years old enrolled in a day-care center at a Marine base.

Of those families, 55 (33 percent) had a deployed parent, with an average deployment length of 3.9 months. The researchers found that children aged three years and older with a deployed parent had significantly higher scores on measures of externalizing and overall behavior problems than children of the same age without a deployed parent.

"Such reported differences might be dismissed as distorted perceptions of the child by the distressed non-deployed parent; however, the association remained after controlling for parental stress and depressive symptoms," wrote Dr. Molinda M. Chartrand, of the Boston University School of Medicine and Boston Medical Center, and colleagues.

"Larger, longitudinal studies are needed to ascertain whether there are changes in children's behavior from the time before parental deployment, during parental deployment, and at the time of reunification," the researchers added.

"This information is necessary to provide clinicians serving military families with evidenced-based anticipatory guidance and clinical interventions. Finally, the needs of the children of deployed parents in the National Guard and Reserves also warrant urgent further education."

The study was published in the November issue of the Archives of Pediatrics & Adolescent Medicine.

"Findings from this study highlight the need for increased attention to mental health concerns of young children of deployed soldiers as well as the mental health concerns of the soldiers and non-deployed spouses," David J. Schonfeld and Robin Gurwitch, of the Cincinnati Children's Hospital Medical Center, wrote in an accompanying editorial. "[The study authors] raise questions of how to best determine deployment length and what preventive measures can be taken to reduce stress and distress to the non-deployed spouses and children left behind."

More than 2 million American children have had parents deployed to Iraq or Afghanistan, and about 40 percent of those children are younger than 5.

MONDAY, Nov. 3 (HealthDay News) -- Japanese scientists have succeeded in creating cloned mice from mouse bodies that had been frozen for up to 16 years.

While the feat may raise the specter of resurrecting lost species a la Jurassic Park, study senior author Teruhiko Wakayama said recreating woolly mammoths was "probably impossible."

He and his co-authors did acknowledge, however, the possibility of preserving endangered species and perhaps resurrecting other extinct species.

Other experts thought the implications of such technology could be more immediate -- and more human.

"Learning how to manipulate stem cells is an important enterprise, and scientists should be fully engaged in this. Whether we apply it toward bringing back dinosaurs or taking care of real needs on this planet is another question," said Richard Finnell, professor in the Center for Environmental and Genetic Medicine at the Texas A&M Health Science Center Institute of Biosciences and Technology.

"Stem cell biology offers tremendous upside, [but] the technology needs to be refined, and these scientists have come up with a way to manipulate these stem cells," Finnell continued. "Science is an interdisciplinary process. If we can grasp a technique that has been used for one approach, it really could be quite beneficial to how we deal with clinical problems today."

Scientists have cloned other species -- including celebrity sheep Dolly -- by using two live cells. Genetic material is taken from an unfertilized egg and then transferred to another live cell for "incubation," a process known as nuclear transfer.

Until now, researchers had believed that ice crystals formed in frozen cells would cause irreparable damage to the DNA, making cloning of long-dead animals impossible.

Wakayama, of the Laboratory for Genomic Reprogramming at the Center for Developmental Biology in Kobe, Japan, and his colleagues took brain tissue from a mouse strain frozen at minus 20 degrees Celsius for up to 16 years and transferred the nuclei (containing the genetic material) to empty egg cells.

These two-cell embryos were used to generate embryonic stem cell lines that resulted in 12 healthy cloned mice, which grew into normal adults.

The technique did not require nuclei from an intact donor cell. The cloning efficiency was about the same as using conventional cloning methods, the study authors stated.

The number of children on medication for chronic illnesses in the United States went up between 2002 and 2005 across a range of diseases, with a doubling of medication for type 2 diabetes, according to a new study.

The study was the work of lead author Dr Emily Cox of Express Scripts, Inc, St Louis, Missouri, and colleagues from other research centres in the US, and was published online on 31 October in the journal Pediatrics.

The researchers investigated commercial medical insurance claims made between 2002 and 2005 for a nationally representative sample of more than 3.5 million children aged from 5 to 19 years.

For each quarter of the three years covered by the study the researchers noted use of medication for the following chronic conditions: high blood pressure (antihypertensives), high blood fats (antihyperlipidemics), type 2 diabetes, antidepressants, asthma, attention deficit disorder and attention- deficit/hyperactivity disorder.

The results showed that:

The figures for medication use in the first quarter of the study period (first three monts of 2002, the baseline quarter) ranged from 29.5 per 1,000 child patients for asthma medication to 0.27 per 1,000 for antihyperlipidemics.

Except for asthma medication, the prevalence for older children, aged 15 to 19, was higher than for those who were younger than this.

The prevalence for type 2 diabetes medication doubled over the three years of the investigation.

This was driven mostly by a 166 per cent rise among females aged 10 to 14 and 135 per cent among females aged 15 to 19.

The highest rates of prevalence increase (in the double digits) were in medications for: asthma (46.5 per cent), attention-deficit disorder and attention-deficit/hyperactivity disorder medications (40.4 per cent), and antihyperlipidemics (15 per cent).

This compared with a more moderate growth in the use of antihypertensives and antidepressants (1.8 per cent).

The increase in prevalence rates for type 2 diabetes medication was far more dramatic for girls than for boys (147 versus 39 per cent).

There was a similar pattern for attention-deficit disorder and attention-deficit/hyperactivity disorder medications (63 versus 33 per cent), and antidepressants (7 versus 4 per cent).

In reporting their findings the authors commented that:

"Varying patterns were noted between males and females and across age groups. Particularly noteworthy are growing rates of use among female children, at times rates twice as great as among males."

"These findings hold important implications for children's health and health care costs in the United States," they added.

And they concluded that:

"Prevalence of chronic medication use in children increased across all therapy classes evaluated. "

Sunday, November 2, 2008

The research from the University of Alabama at Birmingham (UAB) showed that parathyroid hormone (PTH) given intermittently enhances the body's own bone-building action through a specific "co-receptor" on the surface of bone cells.

While scientists have known for long that PTH stimulates bone formation, the exact mechanism underlying this effect has been unknown to date.

"Our study uncovers a novel mechanism for how parathyroid hormone signaling selectively stimulates bone formation. We have identified the protein co-receptor crucial to the whole process," said Dr. Xu Cao, UAB professor of pathology and senior author on the study.

During the study, the researchers focused on PTH signals in mice to see which cell receptors would actively recruit calcium from the blood.

Dr. Mei Wan, UAB associate professor of molecular and cellular pathology and first author on the study, said that the team's efforts helped uncover the one co-receptor responsible for turning on bone building.

Dr. Jay McDonald, pathology professor and director of UAB's Center for Metabolic Bone Disease, pointed out that the exact mechanism of PTH-signalled bone formation was previously shrouded by the joint production of osteoblasts and osteoclasts, two types of cells that are instrumental in regulating a healthy skeleton.

While osteoblasts regulate a healthy skeleton by forming new bone, and osteoclasts do so by resorbing old and brittle bone.

McDonald highlighted the fact that many existing osteoporosis drugs target both osteoblasts and osteoclasts, which can lead to zero or minimal bone formation.

"The ideal would be to have one drug to shut down the osteoclasts and turn on the osteoblasts to effectively build bone. We don't have that yet, but this study shows us the path to get there," he said.

The primary purposes of the new guideline, for patients 18 years and older, are to improve quality of care and outcomes for BPPV by improving the accurate and efficient diagnosis of the condition, reducing the inappropriate use of suppressant medications, decreasing the inappropriate use of ancillary tests such as radiographic imaging and vestibular testing, and to promote the use of effective repositioning maneuvers for treatment.

BPPV is a disorder that causes feelings of vertigo, dizziness, and nausea. Episodes of BPPV can be brought on by abrupt changes in movement, like standing up or turning the head suddenly. The condition usually begins to affect people after the age of 50, but it can affect younger patients.

"Approximately 5.6 million medical appointments per year in the United States can be attributed to complaints of dizziness," said Neil Bhattacharyya, chair of the multidisciplinary BPPV Guideline Panel. "We know now that anywhere from 17 to 42 percent of these patients will ultimately receive a diagnosis of BPPV. Unfortunately, proper diagnosis and treatment for those suffering is often delayed due to a lack of standardized diagnostic steps and relative unawareness of effective treatment options."

Expenses relating to the diagnosis and treatment of BPPV cost the U.S. healthcare system approximately $2 billion per year. Additionally, 86 percent of patients suffer some interrupted daily activities and lost days at work because of BPPV.